Occult spina bifida and lumbar disc herniation can be differentiated based on etiology, symptoms, and imaging. 1. Etiology: Occult spina bifida is a disease due to congenital developmental abnormality, which mainly occurs in infants and young children, mostly in the lumbosacral region; lumbar disc herniation is mostly due to nucleus pulposus protruding after degeneration or rupture of the discs after acquired, which occurs mostly in the middle-aged and elderly people. 2. Symptoms: occult spina bifida can have lumbosacral pressure pain, percussion pain and radiating pain, etc., lumbar disc herniation is mainly sciatic nerve launching pain; occult spina bifida straight leg elevation test is negative, lumbar disc herniation straight leg elevation test is positive. 3. Imaging: on X-ray, occult spina bifida can be seen in the 5th lumbar vertebra and the 1st sacral vertebra with unhealed fissure; lumbar disc herniation lumbar lateral curvature, physiological anterior flexion is reduced or disappeared; in addition, lumbar disc herniation in CT can be observed in the lumbar disc herniation and other signs. In case of occult spina bifida or lumbar disc herniation, it is recommended to go to the hospital in time, improve the examination to clarify the cause of the disease, and then give targeted treatment or therapy.